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NEJM：皮肤放线菌病-案例报道

2016-05-05 chenshuo译 MedSci原创

放线菌清创术抗生素
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http://www.nejm.org/doi/full/10.1056/NEJMicm1511213?query=featured_clinical-practice

男性，33岁，在2015年因其左膝盖皮肤出现溃疡病变几年而入院就诊。

 
据该患者称，在2010年他曾发生过一次机动车碰撞事故，当时导致了他的左膝盖浅表组织擦伤和骨折。2年后，该患者发现其左膝盖皮肤开始增厚并可见几处范围小于1cm的皮下结节，不久左膝盖的内外侧和大腿也出现了类似的皮肤病变。其当时无出现发热等全身症状。于是遵医嘱应用一些常规的抗生素进行治疗，症状有所改善。

常规体格检查可见，其左膝盖仍有水肿、红斑、色素沉着、角化过度，以及几个结节结痂及窦道，但无脓肿或渗出现象（如图A和B）。

此外，该患者左膝盖的感觉减退，但运动功能和肌力仍然正常。

最后，患者接受了局部清创术，术后细菌培养证实了放线菌的存在（如图C观察到的Hoeppli现象）。同时，该患者坚持口服阿莫西林克拉维酸药物1年进行治疗，症状明显有所好转，但尚未完全康复（如图D）。 

原始出处：

Juan C. Cataño, M.D., and Sara Isabel Gómez Villegas, B.S. Cutaneous Actinomycosis

N Engl J Med 2016; 374:1773May 5, 2016

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  1. [GetPortalCommentsPageByObjectIdResponse(id=2083617, encodeId=10e3208361e2a, content=<a href='/topic/show?id=ecb05e4399a' target=_blank style='color:#2F92EE;'>#放线菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57439, encryptionId=ecb05e4399a, topicName=放线菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Jan 23 23:52:00 CST 2017, time=2017-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128581, encodeId=69951285818a, content=不错哦，会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 11:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106966, encodeId=247810696657, content=深入学习，好文值得点赞！, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 20:37:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85127, encodeId=e9368512ece, content=有点恐怖啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=184, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Mon May 09 21:28:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84739, encodeId=c8b884e39eb, content=看看医生们需要面对的, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Sun May 08 13:46:00 CST 2016, time=2016-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84738, encodeId=806284e3852, content=不敢直视, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Sun May 08 13:45:00 CST 2016, time=2016-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84512, encodeId=d71a8451265, content=好恐怖！, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sat May 07 16:38:00 CST 2016, time=2016-05-07, status=1, ipAttribution=)]
    2017-01-23 howi

    #放线菌#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2083617, encodeId=10e3208361e2a, content=<a href='/topic/show?id=ecb05e4399a' target=_blank style='color:#2F92EE;'>#放线菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57439, encryptionId=ecb05e4399a, topicName=放线菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Jan 23 23:52:00 CST 2017, time=2017-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128581, encodeId=69951285818a, content=不错哦，会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 11:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106966, encodeId=247810696657, content=深入学习，好文值得点赞！, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 20:37:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85127, encodeId=e9368512ece, content=有点恐怖啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=184, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Mon May 09 21:28:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84739, encodeId=c8b884e39eb, content=看看医生们需要面对的, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Sun May 08 13:46:00 CST 2016, time=2016-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84738, encodeId=806284e3852, content=不敢直视, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Sun May 08 13:45:00 CST 2016, time=2016-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84512, encodeId=d71a8451265, content=好恐怖！, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sat May 07 16:38:00 CST 2016, time=2016-05-07, status=1, ipAttribution=)]
    2016-09-16 1e10c84am36(暂无匿称)

    不错哦，会学到很多

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2083617, encodeId=10e3208361e2a, content=<a href='/topic/show?id=ecb05e4399a' target=_blank style='color:#2F92EE;'>#放线菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57439, encryptionId=ecb05e4399a, topicName=放线菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Jan 23 23:52:00 CST 2017, time=2017-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128581, encodeId=69951285818a, content=不错哦，会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 11:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106966, encodeId=247810696657, content=深入学习，好文值得点赞！, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 20:37:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85127, encodeId=e9368512ece, content=有点恐怖啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=184, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Mon May 09 21:28:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84739, encodeId=c8b884e39eb, content=看看医生们需要面对的, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Sun May 08 13:46:00 CST 2016, time=2016-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84738, encodeId=806284e3852, content=不敢直视, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Sun May 08 13:45:00 CST 2016, time=2016-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84512, encodeId=d71a8451265, content=好恐怖！, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sat May 07 16:38:00 CST 2016, time=2016-05-07, status=1, ipAttribution=)]
    2016-08-29 ylzr123

    深入学习，好文值得点赞！

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2083617, encodeId=10e3208361e2a, content=<a href='/topic/show?id=ecb05e4399a' target=_blank style='color:#2F92EE;'>#放线菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57439, encryptionId=ecb05e4399a, topicName=放线菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Jan 23 23:52:00 CST 2017, time=2017-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128581, encodeId=69951285818a, content=不错哦，会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 11:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106966, encodeId=247810696657, content=深入学习，好文值得点赞！, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 20:37:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85127, encodeId=e9368512ece, content=有点恐怖啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=184, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Mon May 09 21:28:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84739, encodeId=c8b884e39eb, content=看看医生们需要面对的, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Sun May 08 13:46:00 CST 2016, time=2016-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84738, encodeId=806284e3852, content=不敢直视, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Sun May 08 13:45:00 CST 2016, time=2016-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84512, encodeId=d71a8451265, content=好恐怖！, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sat May 07 16:38:00 CST 2016, time=2016-05-07, status=1, ipAttribution=)]
    2016-05-09 jaysppr

    有点恐怖啊

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2083617, encodeId=10e3208361e2a, content=<a href='/topic/show?id=ecb05e4399a' target=_blank style='color:#2F92EE;'>#放线菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57439, encryptionId=ecb05e4399a, topicName=放线菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Jan 23 23:52:00 CST 2017, time=2017-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128581, encodeId=69951285818a, content=不错哦，会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 11:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106966, encodeId=247810696657, content=深入学习，好文值得点赞！, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 20:37:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85127, encodeId=e9368512ece, content=有点恐怖啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=184, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Mon May 09 21:28:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84739, encodeId=c8b884e39eb, content=看看医生们需要面对的, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Sun May 08 13:46:00 CST 2016, time=2016-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84738, encodeId=806284e3852, content=不敢直视, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Sun May 08 13:45:00 CST 2016, time=2016-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84512, encodeId=d71a8451265, content=好恐怖！, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sat May 07 16:38:00 CST 2016, time=2016-05-07, status=1, ipAttribution=)]
    2016-05-08 stead

    看看医生们需要面对的

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2083617, encodeId=10e3208361e2a, content=<a href='/topic/show?id=ecb05e4399a' target=_blank style='color:#2F92EE;'>#放线菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57439, encryptionId=ecb05e4399a, topicName=放线菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Jan 23 23:52:00 CST 2017, time=2017-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128581, encodeId=69951285818a, content=不错哦，会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 11:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106966, encodeId=247810696657, content=深入学习，好文值得点赞！, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 20:37:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85127, encodeId=e9368512ece, content=有点恐怖啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=184, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Mon May 09 21:28:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84739, encodeId=c8b884e39eb, content=看看医生们需要面对的, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Sun May 08 13:46:00 CST 2016, time=2016-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84738, encodeId=806284e3852, content=不敢直视, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Sun May 08 13:45:00 CST 2016, time=2016-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84512, encodeId=d71a8451265, content=好恐怖！, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sat May 07 16:38:00 CST 2016, time=2016-05-07, status=1, ipAttribution=)]
    2016-05-08 stead

    不敢直视

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2083617, encodeId=10e3208361e2a, content=<a href='/topic/show?id=ecb05e4399a' target=_blank style='color:#2F92EE;'>#放线菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57439, encryptionId=ecb05e4399a, topicName=放线菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Jan 23 23:52:00 CST 2017, time=2017-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128581, encodeId=69951285818a, content=不错哦，会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 11:48:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106966, encodeId=247810696657, content=深入学习，好文值得点赞！, beContent=null, objectType=article, channel=null, level=null, likeNumber=1, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Mon Aug 29 20:37:00 CST 2016, time=2016-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85127, encodeId=e9368512ece, content=有点恐怖啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=184, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEIsrUxHnicsiaqwzJibCks60HOicbEAgbNzUiciboMJDzsWg16OHTeNHhyYvTg6TDXTlOx7icnhttCYYe2ujYt0yND7dYusOsibl9XnQCE/0, createdBy=7ad21722200, createdName=jaysppr, createdTime=Mon May 09 21:28:00 CST 2016, time=2016-05-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84739, encodeId=c8b884e39eb, content=看看医生们需要面对的, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Sun May 08 13:46:00 CST 2016, time=2016-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84738, encodeId=806284e3852, content=不敢直视, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160509/IMG572FCF18A71237916.jpg, createdBy=d0861720708, createdName=stead, createdTime=Sun May 08 13:45:00 CST 2016, time=2016-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=84512, encodeId=d71a8451265, content=好恐怖！, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sat May 07 16:38:00 CST 2016, time=2016-05-07, status=1, ipAttribution=)]
    2016-05-07 1dd8c52fm63(暂无匿称)

    好恐怖！

    0

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